Prevalence, determinants, and clinical relevance of MRI signs of osteitis pubis in the large population-based cohort SHIP

Objectives To assess the prevalence of parasymphyseal bone marrow oedema (BME) and cleft signs (CS) in pelvic 1.5-Tesla MRI of a general population sample, to evaluate associations with potential determinants, and to assess whether these findings relate to available self-reported pain variables.Methods A random sample of 1,000 subjects (mean age 51.5 years; 52% female) from the SHIP-Trend-0 cohort underwent standardized pelvic MRI using a coronal TIRM sequence.BME was assessed regarding laterality, extent, and signal intensity; CS were classified as present or absent.Associations with age, sex, BMI, sports activity, occupation, number of pregnancies, and available pain variables were analyzed exploratively using chi-square tests, Mann-Whitney U tests, and binary logistic regression.Results After exclusion of 14 non-diagnostic examinations, 986 subjects were analyzed.BME was detected in 11.1% (95% CI 9.2%-13.2%),with bilateral distribution in 5.5%.Mean BME extent was 8.9 mm.CS were present in 6.0% (95% CI 4.7%-7.6%).BME was not associated with sex, BMI, sports activity, occupation, or available pain variables.CS were more frequent in women (p = 0.015).Number of pregnancies showed a borderline exploratory association with BME (OR 1.238 per pregnancy, 95% CI 1.008-1.521,p = 0.042).Conclusion Parasymphyseal BME and CS are relatively frequent MRI findings in the general population (11.1% and 6.0%).No association was detected with available pain, sports activity, or occupation variables, but findings require cautious interpretation given non-specific symptom assessment and exploratory analyses.These background prevalences should be considered when evaluating suspected osteitis pubis to avoid overdiagnosis.